This is a link to a recent column by Andres Oppenheimer of the Miami Herald. http://www.dallasnews.com/sharedcontent/dws/dn/opinion/viewpoints/stories/DN-oppenheimer_20edi.State.Edition1.2687c3a.html
There has been rapid growth and intense interest in medical tourism in recent years. At a recent medical tourism conference in Los Angeles, there 200+ speakers and over 2000 attendees. Dozens of countries are touting their medical care and supporting contruction of thousands of hopital beds to serve these tourists. Powerful interests are betting that millions of US citizens will seek health care outside the US.
It is not immediately clear how this business model might translate to serve US patients covered by Medicare or Universal healthcare. The Miami Herald article identifies the key. The US Health Care Financing Administration could be authorized to pay for US beneficiaries "living" in Mexico (or other accredited places). Presto! Costs are lowered by 50% or more.
Competition is a good thing to improve service and lower cost. The problem is that US medicine is structured so that it cannot compete. The effect of such a payment policy would be to shutdown significant parts of US medicine. The complex maze of regulation, third party payments, and the legal system defies reform. US based providers with be hard pressed to compete with foreign providers that only had to "accredit" hospitals and doctors. Could health care be out sourced? Like heavy manufacturing?
A quietly negotiated deal between country presidents and a simple administrative change to the payment regime could set the process in motion. It isn't hard to imagine a substantial decline in US based specialists. Was this a great country or what?